(no subject)
Aug. 21st, 2009 03:29 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
orneriehmmm
if we get a national health care option, and everyone who doesnt have private insurance gets on it, and then there's a major H1N1 pandemic like they're predicting this fall....
that's gonna suck. cause it will still be a new system, without the financial resources built up to handle a large scale payout so early in the game.
oooo boy.
*toddles off to make sure assets are liquid, bills are paid and job is secure....*
if we get a national health care option, and everyone who doesnt have private insurance gets on it, and then there's a major H1N1 pandemic like they're predicting this fall....
that's gonna suck. cause it will still be a new system, without the financial resources built up to handle a large scale payout so early in the game.
oooo boy.
*toddles off to make sure assets are liquid, bills are paid and job is secure....*
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no subject
Date: 2009-08-21 11:23 pm (UTC)And if it doesn't pass
Date: 2009-08-21 11:59 pm (UTC)The system as it exists currently is FAR more expensive.
Re: And if it doesn't pass
Date: 2009-08-22 12:29 am (UTC)so messed up in fact that I dont see how they can fix it. and so laced together with so many other facets of our country that I dont see how they can extricate it.
I just wonder if they will ahve thought of the impending epidemic. fortunately its not a super lethal one, so folks wont die (much) but it will still be a major financial hit on a freshy minted system and that doest seem like the most auspicious start....
no subject
Date: 2009-08-22 12:51 am (UTC)no subject
Date: 2009-08-22 12:57 am (UTC)no subject
Date: 2009-08-22 01:05 am (UTC)no subject
Date: 2009-08-22 01:58 am (UTC)no subject
Date: 2009-08-25 04:04 pm (UTC)no subject
Date: 2009-08-25 04:48 pm (UTC)Huh?
Date: 2009-08-22 01:42 am (UTC)Glad I'm not Indian, Chinese, Indonesian, or...many others.
If the flu doesn't kill you in 3 days, you're usually good. So we should be, economically, not that badly affected.
Or am I missing a lot here?
Re: Huh?
Date: 2009-08-22 01:58 am (UTC)fortunately I'm (mostly) in a position where I can do that, but good planning will help limit impact....
maybe I shouldnt be reading those CDC updates :)
no subject
Date: 2009-08-22 04:52 am (UTC)no subject
Date: 2009-08-22 02:42 pm (UTC)If I was in charge, (and I'm not) the health care reform would consist of
1. rquiring insurance, like they do car insurance
2. requiring employers to provide it or at least help (ex: part timers)
3. if you dont have a job, you get signed up on a government plan, and it should be the same plan state employees have.
have no idea how to pay for this :)
I am also fully aware that this plan will likely mean I dont have a job. When government mandates pricing/prescription protocols for drugs (as has happened just last year with Epo) it will lower costs, sure, but it also means a large segment of the population wont hae access. a significant part of our drug sales come from medicare. last time? we had 30% layoffs.
the jury is still out on the incrased death toll. (for those who dont follow such thngs, Epo is a drug that incrases your red blood cell count. patients undergoing chemo get super anemic. this means they're tired and miserable, not to mention needing transfusions which are dangerous, and being more susceptible to infections and other diseases. Last year (give or take) the government decided that the current dosing guidelines were too generous, and stated that for medicare reimbursement, the physician had to prove that their hematocrit was dangerously low, that it had been dangerously low for a while and that they hadnt been dangerously low before.
if insurance wont pay for it, the patients wont get it. that's what "we can set prices to keep them low" means.
I'm all for a national health care plan. but I dont want my government deciding that a drug is too expensive or what is best for me based on cost. that is for my physician and me to decide.
Current system..
Date: 2009-08-22 06:50 pm (UTC)And of course, this is what the insurance companies are doing now.
Re: Current system..
Date: 2009-08-23 02:27 am (UTC)what insurance company and the availability of good plans is considered a benefit, and so is a major hiring and retention point with companies. I know for my company I could choose between an HMO (where prices are set) or a regular payer system...
crappy insurance is a reason not to take (or stay) with a job. now, this might be changing as the job market gets more competitive, dunno....
Re: Current system..
Date: 2009-08-24 05:31 am (UTC)The health insurance market is not free, it is a racket.
Re: Current system..
Date: 2009-08-24 03:36 pm (UTC)I wonder if the difference is california vs washington?
no subject
Date: 2009-08-24 05:22 am (UTC)I hate the idea of requiring everybody to purchase insurance. I especially hate the idea of Federal subsidies to assist lower-income people with that requirement - it's a massive subsidy directly to the health-insurance industry! WTF is that about? Socialism for the rich?
You want only your physician and you to decide what's best for you, regardless of cost? Think that through. Cost isn't a factor? The payer doesn't have any say in the decision? Money is no object? Would you say the same if it was your own money, or if it were someone else's?
The fact is that cost has to be controlled, and that means injecting some form of cost/benefit analysis into medical decisions. Right now everybody seems to be pretending that this isn't already happening (insurers make these kinds of decisions routinely, and their interests are not aligned with the patients') and that it will never be necessary. Crazy shit happens when we don't face up to reality.
National basic health insurance, run by a Federal agency, paid mostly by employers (payroll tax basically offsetting the cost of employer-provided health care, with a net savings coming from reduced staff overhead), with private insurers offering supplemental policies for expanded care to those who want and can pay for it. That works in other countries, it would work here. That's what I want.
Basic question that we as a society have to answer: Is health care a right, or a privilege? If the latter, then we should each pay for it according to our means (more or less the way it works now). If the former, then it should be a collective responsibility of society. If we can't answer the question, we can't solve any of the problems.
no subject
Date: 2009-08-24 03:41 pm (UTC)requiring someone to HAVE insurance and requiring them to BUY it are too different things.
I think everyone should be required to have it. either through their employer, or through a government plan. it would be the responsiblity of the employer or govt to see that they had it.
there should be no out of pocket for basic stuff. if you want supplimental stuff, then you can pay or buy a supplimental plan (or pick a job that provides it)
again, I am sure this is totally unworkable and have no idea how to pay for it :)
does that clarify my point a bit better?
no subject
Date: 2009-08-24 03:50 pm (UTC)You want only your physician and you to decide what's best for you, regardless of cost? Think that through. Cost isn't a factor? The payer doesn't have any say in the decision? Money is no object? Would you say the same if it was your own money, or if it were someone else's?
actually, yes.
but then I'm probably more informed than your average health care consumer, I'll grant you.
and it IS my money. I pay 100s of dollars a month for my health care right now (some as flex care money, some as the payment I agreed to make to have the insurance plan I picked, some as benefits that my employer pays in instead of more money in my paycheck). when I've maxed out, they stop paying (as happened last year for me). so I think I do a pretty good job of weighing cost benefit ratios, at least for me.
now, is my ability to work worth paying out for, more than someone elses? I guess thats what you mean by cost:benefit ratio?
I am fully aware that for socialized medicine to succeed, thos are exactly the type of decisions that will be made. but that doesnt mean I have to like it...
and I thiank you hit it on the head... there are some basic society choices we need to make, and frankly I dont know that our nation is ready to do that....
no subject
Date: 2009-08-22 03:25 pm (UTC)I think one thing that I notice is how much the word "pandemic" can be associated with the word "panic" and how easy it is to merge those words on the unconscious level. And I wonder if some news organizations take advantage of that?
no subject
Date: 2009-08-22 04:26 pm (UTC)I found it very interesting that this public outcry on the pandemic happened about the time major public health funding was being threatened..... so i twouldnt suprise me a bit if it wasnt a combo of news wanting to sell stories, and public health offices trying to justify their exhistance to a jaded misinformed public.
pandemic just means a disease wave thats spread worldwide....but as you point out, Joe Public adds in the bit about LETHAL OMG WE"RE ALL GOING TO DIE!!!!
dont tell anyone, but I'm not sure I'm gonna correct him, if that means public funding manages to maintain a good level I'm ok with that :)
no subject
Date: 2009-08-22 04:40 pm (UTC)Speaking of normal, in a bit of a hijack, do you know of a recipe for zucchini bread that is more interesting than the the average? 95% of the zucchini b. I've been given or made myself is nice, but not delicious. I want something that forces the eyelids up.
no subject
Date: 2009-08-23 02:28 am (UTC)I use NF yogurt in mine...do you have access to The Best Recipe, the cookbook from cooks illustrated? their recipe is really good. I add in a bunch of stuff like toasty pecans, extra spices and sometimes chocolate chips :)
no subject
Date: 2009-08-23 02:39 am (UTC)I don't have that recipe book :-( so many books, as they say.
I wonder about baking it in a outdoor brick oven????hummmm
no subject
Date: 2009-08-23 02:59 am (UTC)no subject
Date: 2009-08-22 10:57 pm (UTC)What I don't get is why a public option would suck, and why it it is a good idea to have insurance tied to ones job - I'm self employed, work four different jobs, and noway nohow can afford insurance, it would cost more than my monthly income. I have never been eligible for public assistance of any kind, not even food stamps.
When I am sick, I don't go to the doctor, I keep going to work, and riding on public transit, and shopping at the grocery store, since self-employed means no sick days. I try not to get sick. The USA is full of folks like me, working hard to get by, but without the options the majority take for granted.
According to the June Gallup index, 16% of their respondents had no insurance. Among those making under 36K/year 28.6%. The estimate for artists is about 40%.
and making insurance Mandatory...pray tell how will that help?! I know that car insurance is mandatory, and when it got too expensive, along with the cost of gas and oil, I pulled my old car off the road a year and a half ago and haven't driven it since.
What percentage of net income, (not gross income) do you think is suitable to pay for insurance?
I have no objection to paying my way, but losing my home, or shutting off the utilities, in order to meet a mandated insurance payment is an idea that scares me. There is damn little that I have left to cut from my budget these days, going to SCA events is one of the luxuries that I have pretty much given up these last few years, my only remaining "luxury" is my $30/mo internet access.
no subject
Date: 2009-08-22 11:28 pm (UTC)no subject
Date: 2009-08-23 02:39 am (UTC)I think you may misunderstand me. I think insurance should be required, AND I think that if you dont get it from an employer/ job, you should be able to get it from the government same as you get fire and police coverage.
the reason I think it should be required is severalfold:
1. that for insurance to function it MUST include a large pool to normalize risk. if you skew the population for an insurance gorup to only be those who dont have jobs, etc you will be skewing it heavily to those who cant work. I think you'd agree that most people who dont have insurance would be higher risk? (self employed artists etc being the minority there?) by lumping the state employees (lower risk group) with the unemployable (higher risk group) you average the risk overall. the only way for an insurance pool to work is to average the risk. if you fill the pool with high risk folks? it will not be sustainable.
2. herd immunity is an important factor in public health. if the majority of a population is not at risk for a disease, the rest are protected as well as the disease cannot spread. obviously this doesnt work for non contagious things, but it worked for polio...
3. there is too much haves vs have nots in our society (yes, I'm a bit pink tinged on the corners). basic health care is too important to leave to the whims of employers or life circumstances. it should not be a priviledge, it should be a basic human right. not just because it encourages a healthier population (thereby decreasing the chances of ME getting sick), not just because it makes financial sense (see item #1) but because its the right, moral and human thing to do.
does that help explain my position a bit better?
no subject
Date: 2009-08-23 06:13 am (UTC)I particularly notice that the herd immunity is definitely true - I get sick more often since I started riding the bus, and my friends who either work with young children or have some themselves, get sick more often than anyone else I know.
I understand about how insurance risk pools work, at least as well as any layperson can. Which is why I was really hoping for an everyone-in-the-pool kind of plan, which would spread the risks and the costs across "all of us", as opposed to the kind of patchwork solution that inertia and greed are likely to end us up with (sigh)
For some of the time when I lived in Washington I had Basic Health. It was an affordable option with a sliding scale that was actually realistic. It was a lot better than no insurance, but it certainly did not cover many things that would normally be considered part of medical insurance. (It did cover the surgery on my right hand, but there was no possibility for physical therapy aftercare, for example) The co-pay was high enough that visits to see a doctor were only in cases of definite "need to see, can't fix this at home..." and you never knew what doctor or nurse you would be seeing, but when I had pneumonia, or the time I had campylobactyr from eating Safeway take-out food, it was a good thing to be able to get medical attention.
I wonder why the USA is the ONLY first world country that does not have a national health care option for its people? In all places where there is that kind of option, it is also possible to buy additional or special treatment, if one has the money, but no one goes without care. (Personally, I blame the Protestant Reformation: the idea that those who are right with God will prosper and those who are not prosperous are somehow sinful, and deserve the consequences...but that is another topic entirely)
And I am really curious - what percentage of a persons income do folks think it appropriate to pay for health care (insurance +copay +whatever additional fees)?
no subject
Date: 2009-08-23 06:30 pm (UTC)re: the protestant reformation "god loves me so I have health insurance"....this is almost a direct quote from my boss. I kid you not. I was dumbstruck and quickly changed the subject. *sigh*. there are some things we Do Not Speak Of (tm)......
what percentage of a persons income is appropriate to pay for health care? I think anyone should be able to go to the ER or a primary health care professional and get basic needs taken care of and not have to pay anything out of pocket. I am fully aware that this means a significant increase in taxes. I am ok with that. remember what I said about it being the right, moral and human thing to do? not to mention herd immunity ;) so its not totally altruisitic on my part, believe me ;)
In my magical fairy land, not only would ERs and primary care providers (oo! and basic dental, too, please!) be "free" (ie paid for by the government, so really by taxpayers) but employers would continue to vie for employees retention by creating competitive additional insurance packages, covering things like extended PT, alternative medicine, smoking cessation, upgraded medical devices, etc.
there are probably a million reasons this wont work. but hey, its MY magical fairy land, so there :)
no subject
Date: 2009-08-24 06:54 am (UTC)I'd happily pay more taxes if I could go to the doctor. (and as a self-employed, I'm already paying both the employee and employer tax share for myself)
I've never understood why most health insurance covers aliments and injuries, and often a modest amount of preventative care like "check-ups", but doesn't cover dental work, or opthamology, or podiatry. Last time I checked, my teeth, and my eyes, and my feet were all part of my body...
no subject
Date: 2009-08-24 03:38 pm (UTC)I guess i"m confused? its a given number of dollars a month either way?